        <?php include_partial('global/flash') ?>
        <div class="wrap loan_from_nav">
    <div class="panel panel-primary">
        <div class="panel-heading">
            <h3 class="panel-title">申请房产抵押贷</h3>
        </div>
        <div class="panel-body">
            <div class="alert alert-info">提示：由于业务原因，微美贷平台目前只开放上海房屋抵押贷业务，其他地区暂未开放； 请仔细填写您的真实信息，我们将与您取得联系。</div>
            <div class="from_main wrap loan_from">
                <form class="form-horizontal" role="form" action="<?php echo url_for("loan/housing")?>" method="POST">
            <ul>
                <li>
                    <label class="col-xs-2 control-label">联系人：</label>
                    <div class="col-xs-10">
                        <input type="text" class="form-control" id="username" name="Contact">
                    </div>
                </li>
                <li>
                    <label class="col-xs-2 control-label">手机号码：</label>
                    <div class="col-xs-10">
                        <input type="tel" class="form-control" id="mobile" name="Mobile">
                    </div>
                </li>
                <li>
                    <label class="col-xs-2 control-label">意向融资金额：</label>
                    <div class="col-xs-10">
                        <div class="input-group">
                            <input type="text" class="form-control" name="Amount">
                            <span class="input-group-addon">万元</span>
                        </div>
                    </div>
                </li>
                <li>
                    <label class="col-xs-2 control-label">所在区域：</label>
                    <div class="col-xs-10">
                        <select class="form-control" name="Area">
                            <option value="上海">上海</option>
                        </select>
                    </div>
                </li>
                <li>
                    <label class="col-xs-2 control-label">房屋面积：</label>
                    <div class="col-xs-10">
                        <div class="input-group">
                            <input type="text" class="form-control" name="HousingArea">
                            <span class="input-group-addon">平方米</span>
                        </div>
                    </div>
                </li>
                <li>
                    <label class="col-xs-2 control-label">房龄：</label>
                    <div class="col-xs-10">
                        <div class="input-group">
                            <input type="text" class="form-control" name="HousingAge">
                            <span class="input-group-addon">年</span>
                        </div>
                    </div>
                </li>
                <li>
                    <label class="col-xs-2 control-label">所在小区：</label>
                    <div class="col-xs-10">
                        <input type="text" class="form-control"  name="Village">
                    </div>
                </li>
                <li>
                    <label class="col-xs-2 control-label">预期融资期限：</label>
                    <div class="col-xs-10">
                        <select class="form-control" name="Period">
                            <option value="101">1-3个月</option>
                            <option value="102">4-6个月</option>
                            <option value="103">7-12个月</option>
                        </select>
                    </div>
                </li>
                <li style="height: 90px">
                    <label class="col-xs-2 control-label">备注说明：</label>
                    <div class="col-xs-10">
                        <textarea class="form-control" style="width: 300px; height: 72px; resize: none" name="Remark"></textarea>
                    </div>
                </li>
                <li>
                    <label class="col-xs-2 control-label">验证码：</label>
                    <div class="col-xs-10">
                        <div class="input-group">
                            <input type="text" class="form-control" name="validatorCode">
                            <span class="input-group-addon">
                                <img src="<?php echo url_for('loan/captcha') .'?sid='.md5(time()) ?>" id="authimg" onclick="$('#authimg').attr('src','<?php echo url_for('loan/captcha') ?>?sid=' + Math.random());return false;"/></span>
                        </div>
                    </div>
                </li>
                <li>
                    <label class="col-xs-2 control-label"></label>
                    <div class="col-xs-10">
                        <input type="submit" class="btn btn-primary" value="申请" />
                    </div>
                </li>
            </ul>
        </form>
    </div>
        </div>
    </div>
    
    
</div>
        
<script>
    $("#10002").addClass("on");
</script>